PB2137: SOCIO-DEMOGRAPHIC FEATURES AND TREATMENT PATTERNS OF MULTIPLE MYELOMA PATIENTS IN SPAIN: AN INTERIM ANALYSIS OF DORIANT STUDY
Authors: Carmen Montes-Gaisán, Buenaventura Buendia Ureña, Fernando Escalante, Marta Grande, Mercedes Gironella, Andrea Naves, Jesús Aparicio
Journal: HemaSphere (2023)

Topic: 14. Myeloma and other monoclonal gammopathies - Clinical Background: Multiple Myeloma (MM) is a heterogenous disease characterized by subsequent relapses. The disease becomes more aggressive after each relapse with shorter time between relapses, meaning less duration of response per late line of treatment and consequently, treatment refractoriness. There is increasing evidence to support a treatment paradigm shift from the traditional fixed duration strategy to a continuous therapy approach to improve outcomes in accordance with socio-demographic and clinical patient’s characteristics. The determinants of treatment duration (DoT) and its relationship with survival in real-life practice have been little investigated, including reasons for treatment discontinuation. Aims: To investigate the relationship between DoT and outcomes in clinical practice, analyzing treatment received per line, as fixed duration or continuous therapy, factors that may have an influence in treatment continuation and patients satisfaction with treatment prescribed. Methods: DOrianT is an observational, prospective, non-interventional, multicentric study, involving 14 hospitals in Spain, which enrolled MM, amyloidosis AL and patients with more than one gammopathy to assess the DoT and response in routine clinical practice. At study entry patients were receiving active treatment under a fix-duration or continuous strategy. An interim descriptive analysis has been conducted once 50% of patients have completed the defined 12 months follow up period. The reported information is based on the 207 MM patients enrolled. Results: At study entry and current treatment initiation, median age was 73 (9.73) years, 103 (49.8%) patients were male and 104 (50.2%) female. 49 (23.9%) and 156 (76.1%) lived in rural and urban areas. 17 (8.9%) lived alone, 166 (86.5%) with a family member and 9 (4.7%) lived alone with help of a caregiver. 153 (78.9%) were independent, 25 (12.9%) dependent grade I, 12 (6.2%) grade II and 4 (2.1%) grade III. The majority of patients were retired 155 (78.3%) and 14 (7.1%) were in active employment. 100 (48.3%) patients completed the follow up period, with a median follow up of 11.57 (6.08, 12.19) months. 10 (9.3%) patients abandoned the study prematurely. 107 (51.7%) patients were at 1L of treatment, 59 (28.5%) at 2L, 28 (13.5%) at 3L and 13 (6.3%) at subsequent lines. 38 patients were at maintenance/consolidation setting, 29 (76.3%) at 1L and 9 (23.7%) at 2L. 71 (34.3%) patients received previous SCT, 59 (83.1%) at 1L, 11 (15.5%) at 2L and 1 (1.4%) at 3L. 98 (48.0%) patients were performed a cytogenetic test at treatment initiation, 42 (42.9%) reported high risk and 56 (57.1%) standard risk. ECOG was performed in 96 (47.1%) patients and IMWG Frailty Status was available in 18 (8.8%). Treatment satisfaction questionnaire for medication (TSQM) was performed in 190 (92.7%) patients, 71.9 (15.5) reported convenience with current treatment. Prescribed regimens per line and main agent are listed in table 1. 42 (20.5%) patients received a fixed duration vs 163 (79.5%) continuous treatment strategy. Summary/Conclusion: Based on this preliminary analysis, the majority of MM patients are under a continuous treatment strategy, in early treatment lines and following a treatment based on monoclonal antibodies as main agent. The majority presented concomitant diseases at study entry. ECOG and frailty status are not widely used at routine clinical practice once the treatment is prescribed. Further analysis will be conducted to analyze DoT and its influence with treatment prescribed and patient’s satisfaction.Keywords: Multiple myeloma, Treatment, Monoclonal gammopathy, Real world data